SIF (Idaho State Insurance Fund) is a leader in Idaho workers’ compensation. Because we live and work locally, we recognize that our customers are the backbone of Idaho’s economy and we are proud to offer services that protect their businesses and injured workers, and support their financial strength. We empower our team to put people first, grow professionally, and have fun. At SIF, we’re passionate about Idaho and we’re passionate about what we do.​

We are currently seeking a Claims Examiner I to join our Claims team! ​

As a Claims Examiner I, you will be responsible for managing workers’ compensation claims through the timely and accurate processing of benefits.

​​This position is located in Boise, Idaho and requires employees to be able to work from the SIF office at least two days per week (Tuesdays/Thursdays).​

​We’ll be looking for YOU to: ​

• ​Manage full-cycle of assigned medical and low-complexity time loss workers’ compensation claims, including determining compensability within the required timeframe, interview insureds, injured workers, witnesses and physicians, determining if recommended medical treatment for an injured worker is reasonable and necessary, appropriately reserving funds for the full life of the claim based on a thorough evaluation of the exposure to statutory benefits and determining when to close out a claim once stability has been established.
• Be responsible for timely and frequent communication with injured workers, policyholders and medical providers, accurate data reporting, prompt payment of benefits and maintaining appropriate file documentation.
• ​Provide professional customer service by answering questions and concerns from injured workers, employers and agents to ensure understanding of benefits and laws surrounding benefits.
• ​Verify periods of disability and obtain appropriate documentation to calculate average weekly wage for benefit rate calculation to establish disability payments on low-complexity claims.
• Drive medical case management forward for optimal injured worker recovery.

Establish and manage a return-to-work plan to assist injured workers in returning to the workplace as quickly as possible.

• Identify claims to be escalated based on complexity and assigned client group.
• Review and interpret medical reports and apply findings to claims management.
• Perform other related duties or special projects as required or assigned by Supervisors or Managers.​

​​Your background should include: ​

• High school diploma or equivalent required; Bachelor’s degree preferred.
• Prior knowledge of insurance industry, claims adjusting and medical terminology highly preferred.
• Interview skills with the ability to adeptly gather sensitive and confidential information.
• Proficient use of desktop applications, e.g., Microsoft Office products, to generate emails, forms/letters, reports, and presentations, as well as search and download information from the internet.
• Ability to use critical thinking skills to make independent decisions affecting injured workers and policyholders, as well as SIF.
• Strong written and verbal communication skills with demonstrated experience developing business correspondence and providing exceptional customer service to resolve customer concerns.
• Strong attention to detail and a high level of organizational skill.

What you can expect!​

• ​A fun, collaborative culture
• Work-life balance
• Professional development opportunities that are more than just “talked about”, they actually happen!
• Competitive salary
• Generous paid time off
• Amazing insurance benefits package
• Retirement benefits that rock – membership in PERSI (pension plan) as well as retirement savings options via 401(k) and 457 plans​

​SIF values diversity and we are an equal opportunity employer. Please note that applicants need to have legal authority to work permanently in the U.S.​
​

Job Type: Full-time

Pay: $53,637.00 - $74,100.00 per year

Benefits:

• 401(k)
• Dental insurance
• Employee assistance program
• Flexible schedule
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Parental leave
• Professional development assistance
• Retirement plan
• Tuition reimbursement
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Work Location: One location

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